Evaluation of comprehensive care for older adults in primary care services

Detalhes bibliográficos
Autor(a) principal: Placideli, Nádia
Data de Publicação: 2020
Outros Autores: Castanheira, Elen Rose Lodeiro, Dias, Adriano, Silva, Pedro Alcântara da, Carrapato, Josiane Lozigia Fernandes, Sanine, Patricia Rodrigues, Machado, Dinair Ferreira, Mendonça, Carolina Siqueira, Zarili, Thais Fernanda Tortorelli, Nunes, Luceime Olivia, Monti, José Fernando Casquel, Hartz, Zulmira Maria de Araújo, Nemes, Maria Ines Battistella
Tipo de documento: Artigo
Idioma: eng
por
Título da fonte: Revista de Saúde Pública
Texto Completo: https://www.revistas.usp.br/rsp/article/view/165861
Resumo: OBJECTIVE: To evaluate the performance of comprehensive care for older adults in primary care services in the Brazilian Unified Health System in the state of São Paulo, Brazil. METHODS: A total of 157 primary care services from five health regions in midwestern São Paulo responded, from October to December 2014, the pre-validated 2014 questionnaire for primary care services assessment and monitoring. We selected 155 questions, based on national policies and guidelines on this theme. The responses indicate the service performance in older adults’ care, clustered into three areas of analysis: health care for active and healthy aging (45 indicators, d1), chronic noncommunicable diseases care (89 indicators, d2), and support network in aging care (21 indicators, d3). Performance was measured by the sum of positive (value 1) or negative (value 0) responses for each indicator. Services were clustered according to k-means of the performance scores of each domain. After weighting the domains (Z tests), we estimated the associations between the scores of each domain and independent management variables (typology, planning and evaluation of services), with simple and multiple linear regression. RESULTS: Chronic noncommunicable diseases care (d2) showed, for all clusters, better average performance (55.7) than domains d1 (35.4) and d3 (39.2). Service performance in the general area of planning and evaluation associates with the performance of older adults’ care. CONCLUSIONS: The evaluated services had incipient implementation of comprehensive care for older adults. The evaluation framework can contribute to processes to improve the quality of primary health care.
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spelling Evaluation of comprehensive care for older adults in primary care servicesAvaliação da atenção integral ao idoso em serviços de atenção primáriaHealth Services for Older AdultsComprehensive Health CarePrimary Health CareHealth Services ResearchBrazilian Unified Health SystemServiços de Saúde para IdososAssistência Integral à SaúdeAtenção Primária à SaúdePesquisa sobre Serviços de SaúdeSistema Único de SaúdeOBJECTIVE: To evaluate the performance of comprehensive care for older adults in primary care services in the Brazilian Unified Health System in the state of São Paulo, Brazil. METHODS: A total of 157 primary care services from five health regions in midwestern São Paulo responded, from October to December 2014, the pre-validated 2014 questionnaire for primary care services assessment and monitoring. We selected 155 questions, based on national policies and guidelines on this theme. The responses indicate the service performance in older adults’ care, clustered into three areas of analysis: health care for active and healthy aging (45 indicators, d1), chronic noncommunicable diseases care (89 indicators, d2), and support network in aging care (21 indicators, d3). Performance was measured by the sum of positive (value 1) or negative (value 0) responses for each indicator. Services were clustered according to k-means of the performance scores of each domain. After weighting the domains (Z tests), we estimated the associations between the scores of each domain and independent management variables (typology, planning and evaluation of services), with simple and multiple linear regression. RESULTS: Chronic noncommunicable diseases care (d2) showed, for all clusters, better average performance (55.7) than domains d1 (35.4) and d3 (39.2). Service performance in the general area of planning and evaluation associates with the performance of older adults’ care. CONCLUSIONS: The evaluated services had incipient implementation of comprehensive care for older adults. The evaluation framework can contribute to processes to improve the quality of primary health care.OBJETIVO: Avaliar o desempenho da atenção integral ao idoso em serviços de atenção primária do Sistema Único de Saúde no estado de São Paulo, Brasil. MÉTODOS: Um total de 157 serviços de atenção primária de cinco regiões de saúde do centro-oeste paulista respondeu, de outubro a dezembro de 2014, o instrumento pré-validado Questionário de Avaliação e Monitoramento de Serviços de Atenção Básica 2014. Foram selecionadas 155 questões, com base nas políticas e diretrizes nacionais sobre essa temática. As respostas indicam o desempenho do serviço na atenção ao idoso, agrupadas em três domínios de análise: atenção à saúde para o envelhecimento ativo e saudável (45 indicadores, d1), atenção às doenças crônicas não transmissíveis (89 indicadores, d2) e rede de apoio na atenção ao envelhecimento (21 indicadores, d3). A medida de desempenho foi a soma de respostas positivas (valor 1) ou negativas (valor 0) para cada indicador. Os serviços foram agrupados segundo k-médias dos escores de desempenho de cada um dos domínios. Após a ponderação dos domínios (testes Z), foram estimadas as associações entre os escores de cada domínio e variáveis independentes de gestão (tipologia, planejamento e avaliação dos serviços), por meio de regressão linear simples e múltipla. RESULTADOS: A atenção às doenças crônicas não transmissíveis (d2) mostrou, para todos os agrupamentos, melhor desempenho médio (55,7) do que os domínios d1 (35,4) e d3 (39,2). O desempenho do serviço na área geral de planejamento e avaliação esteve associado ao desempenho da atenção ao idoso. CONCLUSÕES: Os serviços avaliados apresentaram implementação incipiente da atenção integral ao idoso. O quadro avaliativo pode contribuir para processos de melhoria da qualidade da atenção primária à saúde.Universidade de São Paulo. Faculdade de Saúde Pública2020-01-21info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfapplication/xmlhttps://www.revistas.usp.br/rsp/article/view/16586110.11606/s1518-8787.2020054001370Revista de Saúde Pública; Vol. 54 (2020); 6Revista de Saúde Pública; Vol. 54 (2020); 6Revista de Saúde Pública; v. 54 (2020); 61518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPengporhttps://www.revistas.usp.br/rsp/article/view/165861/158741https://www.revistas.usp.br/rsp/article/view/165861/158742https://www.revistas.usp.br/rsp/article/view/165861/158743Copyright (c) 2020 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessPlacideli, NádiaCastanheira, Elen Rose LodeiroDias, AdrianoSilva, Pedro Alcântara daCarrapato, Josiane Lozigia FernandesSanine, Patricia RodriguesMachado, Dinair FerreiraMendonça, Carolina SiqueiraZarili, Thais Fernanda TortorelliNunes, Luceime OliviaMonti, José Fernando CasquelHartz, Zulmira Maria de AraújoNemes, Maria Ines Battistella2020-02-03T02:11:44Zoai:revistas.usp.br:article/165861Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2020-02-03T02:11:44Revista de Saúde Pública - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Evaluation of comprehensive care for older adults in primary care services
Avaliação da atenção integral ao idoso em serviços de atenção primária
title Evaluation of comprehensive care for older adults in primary care services
spellingShingle Evaluation of comprehensive care for older adults in primary care services
Placideli, Nádia
Health Services for Older Adults
Comprehensive Health Care
Primary Health Care
Health Services Research
Brazilian Unified Health System
Serviços de Saúde para Idosos
Assistência Integral à Saúde
Atenção Primária à Saúde
Pesquisa sobre Serviços de Saúde
Sistema Único de Saúde
title_short Evaluation of comprehensive care for older adults in primary care services
title_full Evaluation of comprehensive care for older adults in primary care services
title_fullStr Evaluation of comprehensive care for older adults in primary care services
title_full_unstemmed Evaluation of comprehensive care for older adults in primary care services
title_sort Evaluation of comprehensive care for older adults in primary care services
author Placideli, Nádia
author_facet Placideli, Nádia
Castanheira, Elen Rose Lodeiro
Dias, Adriano
Silva, Pedro Alcântara da
Carrapato, Josiane Lozigia Fernandes
Sanine, Patricia Rodrigues
Machado, Dinair Ferreira
Mendonça, Carolina Siqueira
Zarili, Thais Fernanda Tortorelli
Nunes, Luceime Olivia
Monti, José Fernando Casquel
Hartz, Zulmira Maria de Araújo
Nemes, Maria Ines Battistella
author_role author
author2 Castanheira, Elen Rose Lodeiro
Dias, Adriano
Silva, Pedro Alcântara da
Carrapato, Josiane Lozigia Fernandes
Sanine, Patricia Rodrigues
Machado, Dinair Ferreira
Mendonça, Carolina Siqueira
Zarili, Thais Fernanda Tortorelli
Nunes, Luceime Olivia
Monti, José Fernando Casquel
Hartz, Zulmira Maria de Araújo
Nemes, Maria Ines Battistella
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Placideli, Nádia
Castanheira, Elen Rose Lodeiro
Dias, Adriano
Silva, Pedro Alcântara da
Carrapato, Josiane Lozigia Fernandes
Sanine, Patricia Rodrigues
Machado, Dinair Ferreira
Mendonça, Carolina Siqueira
Zarili, Thais Fernanda Tortorelli
Nunes, Luceime Olivia
Monti, José Fernando Casquel
Hartz, Zulmira Maria de Araújo
Nemes, Maria Ines Battistella
dc.subject.por.fl_str_mv Health Services for Older Adults
Comprehensive Health Care
Primary Health Care
Health Services Research
Brazilian Unified Health System
Serviços de Saúde para Idosos
Assistência Integral à Saúde
Atenção Primária à Saúde
Pesquisa sobre Serviços de Saúde
Sistema Único de Saúde
topic Health Services for Older Adults
Comprehensive Health Care
Primary Health Care
Health Services Research
Brazilian Unified Health System
Serviços de Saúde para Idosos
Assistência Integral à Saúde
Atenção Primária à Saúde
Pesquisa sobre Serviços de Saúde
Sistema Único de Saúde
description OBJECTIVE: To evaluate the performance of comprehensive care for older adults in primary care services in the Brazilian Unified Health System in the state of São Paulo, Brazil. METHODS: A total of 157 primary care services from five health regions in midwestern São Paulo responded, from October to December 2014, the pre-validated 2014 questionnaire for primary care services assessment and monitoring. We selected 155 questions, based on national policies and guidelines on this theme. The responses indicate the service performance in older adults’ care, clustered into three areas of analysis: health care for active and healthy aging (45 indicators, d1), chronic noncommunicable diseases care (89 indicators, d2), and support network in aging care (21 indicators, d3). Performance was measured by the sum of positive (value 1) or negative (value 0) responses for each indicator. Services were clustered according to k-means of the performance scores of each domain. After weighting the domains (Z tests), we estimated the associations between the scores of each domain and independent management variables (typology, planning and evaluation of services), with simple and multiple linear regression. RESULTS: Chronic noncommunicable diseases care (d2) showed, for all clusters, better average performance (55.7) than domains d1 (35.4) and d3 (39.2). Service performance in the general area of planning and evaluation associates with the performance of older adults’ care. CONCLUSIONS: The evaluated services had incipient implementation of comprehensive care for older adults. The evaluation framework can contribute to processes to improve the quality of primary health care.
publishDate 2020
dc.date.none.fl_str_mv 2020-01-21
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
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dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/rsp/article/view/165861
10.11606/s1518-8787.2020054001370
url https://www.revistas.usp.br/rsp/article/view/165861
identifier_str_mv 10.11606/s1518-8787.2020054001370
dc.language.iso.fl_str_mv eng
por
language eng
por
dc.relation.none.fl_str_mv https://www.revistas.usp.br/rsp/article/view/165861/158741
https://www.revistas.usp.br/rsp/article/view/165861/158742
https://www.revistas.usp.br/rsp/article/view/165861/158743
dc.rights.driver.fl_str_mv Copyright (c) 2020 Revista de Saúde Pública
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2020 Revista de Saúde Pública
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
application/xml
dc.publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
dc.source.none.fl_str_mv Revista de Saúde Pública; Vol. 54 (2020); 6
Revista de Saúde Pública; Vol. 54 (2020); 6
Revista de Saúde Pública; v. 54 (2020); 6
1518-8787
0034-8910
reponame:Revista de Saúde Pública
instname:Universidade de São Paulo (USP)
instacron:USP
instname_str Universidade de São Paulo (USP)
instacron_str USP
institution USP
reponame_str Revista de Saúde Pública
collection Revista de Saúde Pública
repository.name.fl_str_mv Revista de Saúde Pública - Universidade de São Paulo (USP)
repository.mail.fl_str_mv revsp@org.usp.br||revsp1@usp.br
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